Women’s Retreat Registration
Please complete this form to register for the Women’s Retreat. Registration is confirmed once the appropriate payment is submitted through Pushpay.
First Name
Last Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
Emergency Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Dietary Restrictions
Church Affiliation
Select Your Payment Option
$300 Pay in Full
$50 Deposit + $50 Monthly Recurring Payments
$50 Deposit Only (No Recurring Payments)
All retreat balances must be paid in full by the final payment deadline.
I understand that: - The $50 deposit is non-refundable - My registration is not complete until payment is submitted through Pushpay - Recurring payments must be canceled by me once my balance is paid in full ☐ I agree to the terms above
I agree to the terms above
Register
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